RESUMEN
Objective: Validate the full-PIERS model in predicting adverse maternal outcomes in women with early-onset preeclampsia with severe features in our population. Methods: Retrospective cohort study. We applied the full-PIERS model on 130 women with severe early-onset preeclampsia who were treated at a second-level hospital in Nuevo León, México. We validated the full-PIERS model in its ability to discriminate through the AUROC. Results: The full-PIERS model applied to the data obtained in our study had good discrimination, revealing an AUC of 0.718 (95% CI 0.515-0.921; P = 0.017). A cut-off of 7.95 was identified as the cut-off point with the best diagnostic performance, with the highest Youden index, presenting a sensitivity of 54.5% and specificity of 99.2% for the development of complications. Conclusion: The full-PIERS model can predict adverse maternal outcomes in women admitted to our hospital with severe early-onset preeclampsia within 48 hours of admission.
RESUMEN
BACKGROUND: metaplastic breast carcinoma (MBC) is uncommon, characterized by a heterogeneous mixture of histologic characteristics. OBJECTIVE: evaluate clinical and pathological characteristics in a population of patients with MBC in a reference center. MATERIALS AND METHODS: retrospective analysis of cases diagnosed with MBC at INCAN database from 2005-2011 was performed. Univariate assessment of clinical variables and their impact on disease free survival(DFS) and overall survival (OS) were evaluated. RESULTS: the records of 20 patients were identified. Median age was 49.5 (range: 33-75). Clinical stages at diagnosis were 6 I-II (30%) and 14 III-IV (70%). Three year OS was 52.1%. Patients< 40 years had an OS of 32.8 months vs. ≥ 40 years of 17.8 (p = 0.097). OS in stage I-II was 13.5 months vs. 23.3 months in III-IV (p = 0.99). Those who received neoadjuvant therapy had an OS of 26.57 vs. 14.36 in those who did not(p = 0.54). Those who received adjuvant therapy had an OS of 31.2 months vs. 11.15 in those who did not (p = 0.036). CONCLUSIONS: MBC has bad prognosis, nevertheless, age < 40 years and hormone receptor positivity, as well as adjuvant treatment seems to be factors that have an influence OS.